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tabling member printed

Lord Willis of Knaresborough

min date

2019-05-21

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To ask Her Majesty's Government by what process, during the current development of
policy options for Academic Health Science Centres (AHSC), potential new AHSCs can
be considered in areas of England currently unrepresented by existing AHSCs.

<p>The Department-designated Academic Health Science Centres (AHSCs) along with the
Academic Health Science Networks (AHSNs) and the National Institute for Health Research
(NIHR) Applied Research Collaborations (ARCs) are all important components of the
country’s health research and innovation ecosystem.</p><p>The six current Department-designated
AHSCs were made on the basis of an open competition, which was open to eligible National
Health Service and University partnerships across England. The recommendations for
designation were made to the Department by an international independent panel.</p><p>The
remit of the Accelerated Access Collaborative (AAC) has recently been expanded to
become the umbrella body across the United Kingdom health innovation eco-system. The
AAC has been asked to consider the role of new AHSCs within the health system and
to ensure that they complement the innovation landscape, rather than add further complexity
to it.</p><p>It is not possible to provide specific details of the scope and nature
of the new designation process at this stage given that the AAC is currently actively
considering this. However, it is expected that the future designation process would
be open to all NHS and University partnerships across England which meet the published
specification to apply, including partnerships in areas of England where there is
currently no Departmental-AHSC. As with the previous AHSC designation process, any
future process will be run via a full and open competition, assessed by an independent
expert panel. Rigorous conflict of interest policies will also be in place throughout
the process for all involved to ensure any potential conflicts are dealt with appropriately.</p><p>The
existing Departmental-AHSC designation will be extended until the end of March 2020
to enable a new designation process to be undertaken. The Department’s expectation
is that AHSCs will play an increasingly important role in the health innovation and
research landscape over the coming years.</p><p>As currently, the success of any newly
designated AHSCs will require close interplay and cooperation between research infrastructure,
including NIHR Biomedical Research Centres (BRCs) and the NIHR ARCs, and with the
AHSNs and wider innovation landscape.</p><p>As part of annual monitoring of the existing
Department-designated AHSCs, examples of innovations arising from them have been reported
to have been made available to patients in the NHS. These include:</p><p>- The King’s
Health Partners Heart Failure Service, which brings together clinical, research and
educational expertise to deliver world class heart care in south London, helping people
with heart failure live longer and with better quality of life;</p><p>- University
College London Partners AHSC adoption of a Learning Health System to standardise data
entry and allowing the widespread trialling of novel tools to detect atrial fibrillation
early;</p><p>- The Manchester AHSC working with partners to align research around
core health and social care priorities; and supporting the roll out of a single blood
test driven decision-aid for patients presenting with chest pain at local emergency
departments; and</p><p>- The roll out of the innovative Sleepio app by the Oxford
AHSN to support those suffering from insomnia across Oxfordshire, Berkshire and Buckinghamshire.</p>

<p>The National Institute for Health and Care Excellence (NICE) is the independent
body responsible for making recommendations for the National Health Service on whether
drugs and other treatments represent a clinically and cost effective use of NHS resources.</p><p>NICE
has recommended the following drugs for the treatment of HER2-positive breast cancer:
trastuzumab emtansine (Kadcyla) for treating HER2-positive advanced breast cancer
after trastuzumab (Herceptin) and a taxane; pertuzumab (Perjeta) with trastuzumab
(Herceptin) and docetaxel for treating HER2-positive breast cancer; pertuzumab (Perjeta)
for the neoadjuvant treatment of HER2-positive breast cancer; and pertuzumab (Perjeta)
for adjuvant treatment of HER2-positive early stage breast cancer.</p><p>NHS commissioners
are legally required to fund drugs recommended in NICE technology appraisal guidance.
It is for clinicians to decide on the most appropriate treatment for an individual
patient based on their clinical judgement and in discussion with the patient.</p>

<p>The National Institute for Health and Care Excellence (NICE) is the independent
body responsible for making recommendations for the National Health Service on whether
drugs and other treatments represent a clinically and cost effective use of NHS resources.</p><p>NICE
has recommended the following drugs for the treatment of HER2-positive breast cancer:
trastuzumab emtansine (Kadcyla) for treating HER2-positive advanced breast cancer
after trastuzumab (Herceptin) and a taxane; pertuzumab (Perjeta) with trastuzumab
(Herceptin) and docetaxel for treating HER2-positive breast cancer; pertuzumab (Perjeta)
for the neoadjuvant treatment of HER2-positive breast cancer; and pertuzumab (Perjeta)
for adjuvant treatment of HER2-positive early stage breast cancer.</p><p>NHS commissioners
are legally required to fund drugs recommended in NICE technology appraisal guidance.
It is for clinicians to decide on the most appropriate treatment for an individual
patient based on their clinical judgement and in discussion with the patient.</p>

To ask Her Majesty's Government what assessment they have made of whether the innovations
arising from the current phase of Academic Health Science Centres are being made available
to patients throughout the NHS.

<p>The Department-designated Academic Health Science Centres (AHSCs) along with the
Academic Health Science Networks (AHSNs) and the National Institute for Health Research
(NIHR) Applied Research Collaborations (ARCs) are all important components of the
country’s health research and innovation ecosystem.</p><p>The six current Department-designated
AHSCs were made on the basis of an open competition, which was open to eligible National
Health Service and University partnerships across England. The recommendations for
designation were made to the Department by an international independent panel.</p><p>The
remit of the Accelerated Access Collaborative (AAC) has recently been expanded to
become the umbrella body across the United Kingdom health innovation eco-system. The
AAC has been asked to consider the role of new AHSCs within the health system and
to ensure that they complement the innovation landscape, rather than add further complexity
to it.</p><p>It is not possible to provide specific details of the scope and nature
of the new designation process at this stage given that the AAC is currently actively
considering this. However, it is expected that the future designation process would
be open to all NHS and University partnerships across England which meet the published
specification to apply, including partnerships in areas of England where there is
currently no Departmental-AHSC. As with the previous AHSC designation process, any
future process will be run via a full and open competition, assessed by an independent
expert panel. Rigorous conflict of interest policies will also be in place throughout
the process for all involved to ensure any potential conflicts are dealt with appropriately.</p><p>The
existing Departmental-AHSC designation will be extended until the end of March 2020
to enable a new designation process to be undertaken. The Department’s expectation
is that AHSCs will play an increasingly important role in the health innovation and
research landscape over the coming years.</p><p>As currently, the success of any newly
designated AHSCs will require close interplay and cooperation between research infrastructure,
including NIHR Biomedical Research Centres (BRCs) and the NIHR ARCs, and with the
AHSNs and wider innovation landscape.</p><p>As part of annual monitoring of the existing
Department-designated AHSCs, examples of innovations arising from them have been reported
to have been made available to patients in the NHS. These include:</p><p>- The King’s
Health Partners Heart Failure Service, which brings together clinical, research and
educational expertise to deliver world class heart care in south London, helping people
with heart failure live longer and with better quality of life;</p><p>- University
College London Partners AHSC adoption of a Learning Health System to standardise data
entry and allowing the widespread trialling of novel tools to detect atrial fibrillation
early;</p><p>- The Manchester AHSC working with partners to align research around
core health and social care priorities; and supporting the roll out of a single blood
test driven decision-aid for patients presenting with chest pain at local emergency
departments; and</p><p>- The roll out of the innovative Sleepio app by the Oxford
AHSN to support those suffering from insomnia across Oxfordshire, Berkshire and Buckinghamshire.</p>

<p>Following, a new, open competition, the Government has recently announced National
Institute of Health Research (NIHR) designation and funding for 15 Applied Research
Collaborations (ARCs), with total funding of £135 million over five years from 1 October
2019.</p><p>Each NIHR ARC will have its own local governance arrangements in place,
with the named Director of each NIHR ARC having responsibility, and authority over,
the NIHR funding awarded to their National Health Service organisations through the
scheme. Under the terms of the NIHR contract, the NIHR ARCs will be required to submit
annual progress reports and can be subject site visits to evaluate progress, performance
and identify key issues.</p><p>All NIHR ARCs are required to ensure that research
is conducted in accordance with the United Kingdom Policy Framework for Health and
Social Care Research and the Concordat to Support Research Integrity and the Governance
Arrangements for Research Ethics Committees.</p><p> </p><p> </p>

To ask Her Majesty's Government what the future relationship will be between Academic
Health Science Networks, Academic Health Science Centres and Academic Research Collaborations
with regard to the future applied health science ecosystem.

<p>The Department-designated Academic Health Science Centres (AHSCs) along with the
Academic Health Science Networks (AHSNs) and the National Institute for Health Research
(NIHR) Applied Research Collaborations (ARCs) are all important components of the
country’s health research and innovation ecosystem.</p><p>The six current Department-designated
AHSCs were made on the basis of an open competition, which was open to eligible National
Health Service and University partnerships across England. The recommendations for
designation were made to the Department by an international independent panel.</p><p>The
remit of the Accelerated Access Collaborative (AAC) has recently been expanded to
become the umbrella body across the United Kingdom health innovation eco-system. The
AAC has been asked to consider the role of new AHSCs within the health system and
to ensure that they complement the innovation landscape, rather than add further complexity
to it.</p><p>It is not possible to provide specific details of the scope and nature
of the new designation process at this stage given that the AAC is currently actively
considering this. However, it is expected that the future designation process would
be open to all NHS and University partnerships across England which meet the published
specification to apply, including partnerships in areas of England where there is
currently no Departmental-AHSC. As with the previous AHSC designation process, any
future process will be run via a full and open competition, assessed by an independent
expert panel. Rigorous conflict of interest policies will also be in place throughout
the process for all involved to ensure any potential conflicts are dealt with appropriately.</p><p>The
existing Departmental-AHSC designation will be extended until the end of March 2020
to enable a new designation process to be undertaken. The Department’s expectation
is that AHSCs will play an increasingly important role in the health innovation and
research landscape over the coming years.</p><p>As currently, the success of any newly
designated AHSCs will require close interplay and cooperation between research infrastructure,
including NIHR Biomedical Research Centres (BRCs) and the NIHR ARCs, and with the
AHSNs and wider innovation landscape.</p><p>As part of annual monitoring of the existing
Department-designated AHSCs, examples of innovations arising from them have been reported
to have been made available to patients in the NHS. These include:</p><p>- The King’s
Health Partners Heart Failure Service, which brings together clinical, research and
educational expertise to deliver world class heart care in south London, helping people
with heart failure live longer and with better quality of life;</p><p>- University
College London Partners AHSC adoption of a Learning Health System to standardise data
entry and allowing the widespread trialling of novel tools to detect atrial fibrillation
early;</p><p>- The Manchester AHSC working with partners to align research around
core health and social care priorities; and supporting the roll out of a single blood
test driven decision-aid for patients presenting with chest pain at local emergency
departments; and</p><p>- The roll out of the innovative Sleepio app by the Oxford
AHSN to support those suffering from insomnia across Oxfordshire, Berkshire and Buckinghamshire.</p>

<p>The Department’s National Institute for Health Research (NIHR) is currently recruiting
to 15 clinical trials for people with HER2+ breast cancer via its Clinical Research
Network. The majority of these are commercially funded. To date, a total of 7,986
participants have been recruited to these 15 trials.</p><p>Of the 15 clinical trials,
12 are commercially sensitive, with appropriate cost recovery from the companies.
The data for these commercial trials has been provided from the relevant companies
as ‘commercial in confidence’ hence we are unable to provide details about these trials
such as their titles.</p><p>However, the three clinical trials which are not commercially
sensitive are:</p><p>- Cancer Research UK; NIHR Evaluation, Trials and Studies Co-ordinating
Centre (NETSCC). Title: The UK plasma based Molecular profiling of Advanced breast
cancer to inform Therapeutic Choices (plasmaMATCH);</p><p>- Cancer Research UK. Title:
Response to Optimal Selection of neo-adjuvant Chemotherapy in Operable breast cancer;
and</p><p>- Medical Research Council. Title: A mechanistic non-invasive imaging study
of HER2 expression in breast cancer using [18F]GE-226 positron emission tomography.</p>